Sebelius has been soliciting donations from the health-care
industry, which she oversees, to support a nonprofit
organization’s efforts to publicize the law’s benefits and
encourage enrollment of the uninsured. Her department confirmed
that insurance and pharmaceutical executives were among those
approached for donations.

The Affordable Care Act’s online insurance exchanges are
scheduled to be up and running Oct. 1. For these insurance
markets to work, they must attract young and healthy customers;
otherwise, they risk being overwhelmed by older, sicker patients
who would cause premiums to soar. To enlist healthy subscribers,
the Department of Health and Human Services is already diverting
$150 million intended for new community health centers to public
outreach.

With a recent poll showing four in 10 Americans unaware
that the law was even enacted, and with congressional
Republicans determined to undermine it, Sebelius is right to be
concerned. But her troubles don’t justify soliciting donations
from the health-care industry. Such ties between a government
agency and the industry it oversees may pose a bigger long-term
threat to the law’s credibility and stability than any shortage
of funds.

The Affordable Care Act has already influenced the
allocation of many billions in health-care spending as it
gradually wrenches close to one-fifth of the U.S. economy into a
new configuration. Yet the federal government’s enormous power
over the industry didn’t end with passage of the law. The
government will also determine which health plans can
participate in a federally managed insurance exchange, for
example. What happens if an insurance company that made a
donation at Sebelius’s request subsequently receives approval
for an outsize rate increase?

Given the vast sums involved, it is impossible to keep
political influence entirely at bay. By soliciting donations
from the health-care industry, however, Sebelius is opening the
door to favoritism in a technically difficult, politically
delicate process. She is also making herself, the Obama
administration and the Affordable Care Act itself more
vulnerable to attack from those who wish to scuttle the law.

“With something as personal as health care, it’s
understandable that people are anxious,” President Barack Obama
said. Unfortunately, his health and human services secretary has
given us no reason to calm down.